The present invention relates to pathogen testing, and particularly but not exclusively to systems and methods for the improvement of hand hygiene in a clinical setting.
Hands are the most common way in which microorganisms, particularly bacteria, might be transported and subsequently cause infections, especially in those who are most susceptible to infection. The healthcare setting, in particular, contains a diverse population of microorganisms and this must be considered when caring for those who are susceptible to infection. Although potentially pathogenic microorganisms can be detected in air, water and on surfaces, determining their role in infection can be difficult. It must be considered that contamination of all patient/resident/client environments will occur and must be controlled in some manner.
The transfer of microorganisms from environmental surfaces to patients is largely considered to be via direct (hand) contact with these surfaces, or the direct contact of their healthcare professionals with such surfaces and subsequent contact with the patient. As a consequence, it is widely considered that hand hygiene is paramount in reducing infection spread via this route as well as the appropriate control of the environment. Good hand hygiene is the most important practice in reducing transmission of infectious agents, including Healthcare Associated Infections (HCAI) during delivery of care. The term hand hygiene used in this document refers to the processes used to maintain the cleanliness and hygiene of the hands, including traditional hand washing using soap and water and hand decontamination achieved using other solutions, such as alcohol hand rub/gel.
It is known that hand washing with soap and water is the preferred method of maintaining hand hygiene. Although alcohol hand rub is more convenient and less time consuming than hand washing, repeated use can cause drying of the hands, which in turn results in damage to the hand surfaces, such as cracks and cuts. The damage caused can provide better locations to harbour pathogens, and thereby actually increase the risk of transmitting an infection to a patient. Hand washing does not dry the hands out in this manner, so it is desirable to promote hand hygiene through hand washing.
Furthermore, traditional hand washing with soap and water actively removes harmful bacteria from hands. Hand sanitising gel renders the majority of the harmful bacteria inactive depending on how resistant the bacteria are and how thoroughly the gel is applied to the hands. However, hand-sanitising gel of this type does not remove the bacteria from the hands. It is also known that prolonged use of hand sanitising gel on bacteria can in time make harmful bacteria develop/evolve to become more resistant to the sanitiser and thus more harmful to people. Therefore, it is desirable to promote hand washing over the use of hand sanitising gels.
Various systems and methods for maintaining hand hygiene have been created previously. In particular, the systems disclosed in publications US2009265990A1, WO2014027030A2, GB2458118A, CA2674654A1, and US2011025509A1 are all designed to improve hygiene in a designated area, such as a room with a door. In these systems, a hand sanitiser or soap dispenser is located proximate to a door. Access through the door is prevented or discouraged until the dispenser has dispensed sanitiser. In most cases, a manual override is available in the event that urgent access is required through the door, or an alarm is sounded if the door is opened without prior activation of the dispenser.
A slightly different type of system is disclosed in publications US 2014139339A1 and CA 2807337A1. In these systems, a dispenser is located inside a location where hand hygiene must be maintained, such as a patient's room. The dispenser detects the entry of a person into the room and, if the dispenser is not activated within a predetermined time period from entry, then an alarm is sounded until the dispenser is activated.
However, a common flaw with the abovementioned systems is that there is a presumption that the hand hygiene routine (i.e. hand washing or alcohol hand rubbing) was performed correctly after activation of the dispenser. Therefore, it is relatively easy for these systems to be circumvented (e.g. by activating the dispenser, but not actually performing the hand wash or alcohol rub).
It is apparent then that improvements in the field of hand hygiene are necessary to provide more robust and reliable systems. It is an object of the present invention to provide such an improvement.